Topical Antiandrogens

Topical antiandrogens can be effective in reducing dihydrotestosterone (DHT) levels and promoting hair growth. Kyle Gillett mentions that while some individuals benefit from a systemic decrease in DHT due to conditions such as prostate issues or myocardial hypertrophy, topical solutions specifically target hair-related problems. Common topical antiandrogens include ketoconazole and caffeine. Ketoconazole helps reduce DHT, while caffeine, although weak, can be clinically significant, especially when used with other substances like ketoconazole.

Topical application prevents many of the systemic side effects associated with oral antiandrogens. However, some topicals, like spironolactone and finasteride, may still be absorbed systemically. Spironolactone, due to its molecule size, can enter the bloodstream and should only be used with a doctor's prescription, especially for males. Topical finasteride decreases systemic DHT levels by about 30%, indicating a partial but significant systemic absorption 1.